Sunday, October 22, 2006

Borderline Personality Disorder

I have worked in the counseling field for many years. I have had a number of different case loads and duties. For me the most difficult people to work with are those that are diagnosed with borderline personality disorder. These are clients that will have everyone running around in circles and doing all the work. When ever I find myself disagreeing with another professional about what a particular client needs, I know I am dealing with someone with a borderline personality disorder.This diagnosis is so very frustrating because the person is often times quite intelligent. They are masters at reading people and they know exactly who they will be able to manipulate. At one point in my career I worked for a social service agency dealing with children’s mental health cases. I was assigned sixteen cases to manage. One case had a mother and daughter that were both diagnosed with borderline personality disorder. Each month when I was filling out my case contact information I noticed that thirty percent of my time went towards this one case.People diagnosed with borderline personality disorder are very good at engaging others that they feel can help them get what they want. They usually have the ability to make friends with their excellent social skills. They can talk people out of money and also convince others that they are being picked on or persecuted by the system. They love to surround themselves in drama. They will set up situations to create drama in their lives and then they sit back and watch as others around them run around and try to fix the problems.Treatment for borderline personality disorder is very complex and long term. The person has to be taught how they should feel in various situations and how they should engage others for mutual relationships, rather than use people. These are things that come naturally for most people. Borderline personality disorder is a learned way of behaving. It is not a chemical imbalance of the brain, so there are not medications that can be used to treat the person. Behavior modification techniques and consistent feed back are the most effective ways of getting the individual to live within the parameters of society. This is a long term process and is most effectively accomplished in a group home setting. We are learning that it is best to separate people with various personality disorders from those with classic mental health conditions during the treatment process. The individual with borderline personality disorder, which is most often female, are too skilled at targeting the more vulnerable clients that have an illness verses a disorder.